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Prehospital Care and 24-hour Crash Injury Mortality Among Road Traffic Crash Victims in Addis Ababa, Ethiopia

Received: 1 December 2020     Accepted: 17 December 2020     Published: 2 February 2021
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Abstract

Road traffic crash injuries are critical public health problems that demand on time post crash response to deliver pre-hospital care. Ethiopia is one of the African countries with the worst pre-hospital care delivery platform. This study describes the current practice of pre-hospital service provided for crash injured individuals. A cross-sectional study was conducted among 430 crash victims attending public hospitals in Addis Ababa. Participants were selected by random sampling upon their arrival to the selected hospitals from January 2019 to August 2020. The study described the data using the percentage, median, and interquartile range. The study used binary logistic regression to assess the relationship between pre-hospital care provided and 24-hour crash victim mortality. The median scene time was 20 minutes. More than half of respondents transported to hospital greater than 60 minutes. Among the 430 injured individuals, the fatal crash occurred on 21 (4.9%) individuals. The crash injured individuals received pre-hospital care involving wound care, resuscitations with IV (Intravenous) fluid, and immobilization. Using the binary logistic regression model crash injured patients who did not receive ambulance service were three times more chance of mortality during a 24-hour crash event ((P-value=0.002, AOR=3.1 (95%CI 1.5– 6.4). This study showed that 33.3% of crash-injured individuals received pre-hospital care. The majority of participants arrived at tertiary level trauma hospital with time greater than platinium 10 minutes scene time and golden an hour transport time. Being male, young, and not receiving pre-hospital care were significantly related to early crash injury mortality. A suitable basic and advanced life support strategy should be designed and implemented to enhance timely crash injury care.

Published in Science Journal of Public Health (Volume 9, Issue 1)
DOI 10.11648/j.sjph.20210901.13
Page(s) 23-29
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Crash Injury, Prehospital Injury Care, Road Traffic Crash Injury Mortality

References
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[2] Health Information and Quality Authority. Review of pre-hospital emergency care services to ensure high quality in the assessment, diagnosis, clinical management, and transporting of acutely ill patients to appropriate health facilities. The UK. 2014. www.hike.ie.
[3] Hashmi et al. Trauma Center Access and Pre-Hospital Death J Am Coll Surg. 2018. https://doi.org/10.1016/j.jamcollsurg.2018.09.015 ISSN 1072-7515/18.
[4] Oliver G. J, Walter D. P, Redmond A. D. G. J. Are prehospital deaths from trauma and accidental injury preventable? A direct historical comparison to assess what has changed in two decades. Injury, Int. J. Care Injured. (2017; 48: 978–984. www.e lsevier.com/loca te/ injury.
[5] A 5-year strategy to address road traffic injuries globally Report. Geneva, Switzerland. World Health Organization 2001 http://www.who.int/violence_injury_prevention.
[6] Henry J. A, Reingold A L. Prehospital trauma systems reduce mortality in developing countries: A systematic review and meta-analysis. J Trauma Acute Care Surg 2012; 73 (1): 261-8. DOI: 10.1097/TA.0b013e31824bde1e.
[7] Yehune Meskere, Muluwork Tefera Dinberu, Aklilu Azazh. Patterns and determinants of pre-hospital care among trauma patients treated in Tikur Anbessa Specialized Hospital, emergency department. Ethiop Med J. 2015; 53 (3): 141-9.
[8] Seife H, Teffera E. Epidemiology of road traffic accidents: A Prospective study At a Tertiary University Hospital in Addis Ababa Ethiopia. East & Central African Journal of Surgery. 2015; 20 (1): 3–9.
[9] Paravar M, Hosseinpour M, Salehi S, Mohammadzadeh M, Shojaee A, Akbari H, et al. Pre-hospital Trauma Care in Road Traffic Accidents in Kashan, Iran. Arch Trauma Res. 2013; 1 (4): 166-71.
[10] Seid M, Azazh A, Enquselassie F, Yisma E. Injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia: a prospective hospital-based study. BMC Emergency Medicine. 2015; 15: 10.
[11] Huang C. et al. Characteristics and Outcomes of Patients Injured in Road Traffic Crashes and Transported by Emergency Medical Services. Int. J. Environ. Res. Public Health; 2016; 13 (236): doi: 10.3390/ijerph13020236 www.mdpi.com/journal/ijerph.
[12] Gebresenbet RF, Aliyu AD (2019) Injury severity level and associated factors among road traffic accident victims attending the emergency department of Tirunesh Beijing Hospital, Addis Ababa, Ethiopia: A cross-sectional hospital-based study. PLoS ONE 14 (9): e0222793. https://doi.org/10.1371/journal.pone.0222793.
[13] Bagher A, et al. Analysis of pre-hospital rescue times on mortality in trauma patients in a Scandinavian urban setting. Trauma. 2017; 19 (1): 28–34. DOI: 10.1177/1460408616649217tra.sagepub.com.
[14] Rogers F, Rittenhouse K. The Golden Hour in Trauma: Dogma or Medical Folklore? Journal of Lancaster General Hospital Spring. 2014; l. 9 (1): 1-13.
[15] Newgard C. et al. Revisiting the “Golden Hour”: An Evaluation of Out-of-Hospital Time in Shock and Traumatic Brain Injury. Ann Emerg Med. 2016; 66 (1): 30–41 doi: 10.1016/j.annemergmed.2014.12.004.
[16] Dharap SB, Kamath S, Kumar V. Does prehospital time affect the survival of major trauma patients where there is no prehospital care? J Postgrad Med 2017; 63: 169-75.
[17] Post-crash response: Supporting those affected by road traffic crashes. Geneva, World Health Organization, 2016.
[18] Katayama Y, Kitamura T, Kiyohara K, et al. Prehospital factors associated with death on hospital arrival after a traffic crash in Japan: a national observational study. BMJ Open 2019; 9: e025350. doi: 10.1136/BMJopen-2018-025350.
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Cite This Article
  • APA Style

    Zuriyash Mengistu, Ahmed Ali, Teferi Abegaz. (2021). Prehospital Care and 24-hour Crash Injury Mortality Among Road Traffic Crash Victims in Addis Ababa, Ethiopia. Science Journal of Public Health, 9(1), 23-29. https://doi.org/10.11648/j.sjph.20210901.13

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    ACS Style

    Zuriyash Mengistu; Ahmed Ali; Teferi Abegaz. Prehospital Care and 24-hour Crash Injury Mortality Among Road Traffic Crash Victims in Addis Ababa, Ethiopia. Sci. J. Public Health 2021, 9(1), 23-29. doi: 10.11648/j.sjph.20210901.13

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    AMA Style

    Zuriyash Mengistu, Ahmed Ali, Teferi Abegaz. Prehospital Care and 24-hour Crash Injury Mortality Among Road Traffic Crash Victims in Addis Ababa, Ethiopia. Sci J Public Health. 2021;9(1):23-29. doi: 10.11648/j.sjph.20210901.13

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  • @article{10.11648/j.sjph.20210901.13,
      author = {Zuriyash Mengistu and Ahmed Ali and Teferi Abegaz},
      title = {Prehospital Care and 24-hour Crash Injury Mortality Among Road Traffic Crash Victims in Addis Ababa, Ethiopia},
      journal = {Science Journal of Public Health},
      volume = {9},
      number = {1},
      pages = {23-29},
      doi = {10.11648/j.sjph.20210901.13},
      url = {https://doi.org/10.11648/j.sjph.20210901.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20210901.13},
      abstract = {Road traffic crash injuries are critical public health problems that demand on time post crash response to deliver pre-hospital care. Ethiopia is one of the African countries with the worst pre-hospital care delivery platform. This study describes the current practice of pre-hospital service provided for crash injured individuals. A cross-sectional study was conducted among 430 crash victims attending public hospitals in Addis Ababa. Participants were selected by random sampling upon their arrival to the selected hospitals from January 2019 to August 2020. The study described the data using the percentage, median, and interquartile range. The study used binary logistic regression to assess the relationship between pre-hospital care provided and 24-hour crash victim mortality. The median scene time was 20 minutes. More than half of respondents transported to hospital greater than 60 minutes. Among the 430 injured individuals, the fatal crash occurred on 21 (4.9%) individuals. The crash injured individuals received pre-hospital care involving wound care, resuscitations with IV (Intravenous) fluid, and immobilization. Using the binary logistic regression model crash injured patients who did not receive ambulance service were three times more chance of mortality during a 24-hour crash event ((P-value=0.002, AOR=3.1 (95%CI 1.5– 6.4). This study showed that 33.3% of crash-injured individuals received pre-hospital care. The majority of participants arrived at tertiary level trauma hospital with time greater than platinium 10 minutes scene time and golden an hour transport time. Being male, young, and not receiving pre-hospital care were significantly related to early crash injury mortality. A suitable basic and advanced life support strategy should be designed and implemented to enhance timely crash injury care.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Prehospital Care and 24-hour Crash Injury Mortality Among Road Traffic Crash Victims in Addis Ababa, Ethiopia
    AU  - Zuriyash Mengistu
    AU  - Ahmed Ali
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    UR  - https://doi.org/10.11648/j.sjph.20210901.13
    AB  - Road traffic crash injuries are critical public health problems that demand on time post crash response to deliver pre-hospital care. Ethiopia is one of the African countries with the worst pre-hospital care delivery platform. This study describes the current practice of pre-hospital service provided for crash injured individuals. A cross-sectional study was conducted among 430 crash victims attending public hospitals in Addis Ababa. Participants were selected by random sampling upon their arrival to the selected hospitals from January 2019 to August 2020. The study described the data using the percentage, median, and interquartile range. The study used binary logistic regression to assess the relationship between pre-hospital care provided and 24-hour crash victim mortality. The median scene time was 20 minutes. More than half of respondents transported to hospital greater than 60 minutes. Among the 430 injured individuals, the fatal crash occurred on 21 (4.9%) individuals. The crash injured individuals received pre-hospital care involving wound care, resuscitations with IV (Intravenous) fluid, and immobilization. Using the binary logistic regression model crash injured patients who did not receive ambulance service were three times more chance of mortality during a 24-hour crash event ((P-value=0.002, AOR=3.1 (95%CI 1.5– 6.4). This study showed that 33.3% of crash-injured individuals received pre-hospital care. The majority of participants arrived at tertiary level trauma hospital with time greater than platinium 10 minutes scene time and golden an hour transport time. Being male, young, and not receiving pre-hospital care were significantly related to early crash injury mortality. A suitable basic and advanced life support strategy should be designed and implemented to enhance timely crash injury care.
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Author Information
  • School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

  • School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

  • School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

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